Many obstacles in antimicrobial stewardship (AMS) are shared across high-income countries (HICs) and low and middle-income countries (LMICs). Some of the issues raised in a workshop by the American Thoracic Society on AMS in the Intensive Care Unit (ICU) [1] are universal and could be applied to many different settings: excessively larger-spectrum drugs are often prescribed due to the fear of not covering a specific pathogen with narrow-spectrum antibiotics while waiting on cultures; unnecessary therapy escalation often occurs when a new clinical event, such as fever or hypotension, manifests within hours of therapy initiation, at a time when treatment response did not had enough time to occur or when such events are due to other reasons.
